Nasal Irrigation (Sinus Flush): What You Need To Know

By Sarah Malka, MD
Medically reviewed
October 5, 2021

Nasal irrigation, the process of cleaning out your nose by pouring a saline solution into it, is a centuries-old practice.

And the neti pot—a tool for nasal irrigation that has exploded in popularity in the past decade—has an origin that may surprise you: The world of yoga.

The term “neti pot,” a name for the teapot-like device many people use for nasal irrigation, has its origins in ancient Indian yoga.

Yogis cleaned their noses because they believed clear breathing led to clear thinking.

For the millions of people who suffer from sinus problems, including chronic rhinosinusitis, sinusitis, allergy symptoms, the common cold and other ailments, nasal irrigation is very much modern.

Doctors routinely recommend this practice—also called a “sinus flush”— to patients with a variety of sinus symptoms.

All of the ingredients and tools necessary are available without a prescription. 

Will nasal irrigation help with your symptoms and improve your quality of life?

In this article, I’ll explain what nasal irrigation is, and how to properly perform nasal irrigation.

I’ll also outline potential side effects of performing this procedure on yourself, and discuss some potential risks—and how to avoid them.

I’ll answer whether nasal irrigation works, how often you should do it, and when to see a doctor about your condition.

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What is Nasal Irrigation?

Nasal irrigation is a process for rinsing the inside of your nasal passages with a saline, or saltwater, solution.

This rinsing is often done with a neti pot, which looks like a small teapot that has a long spout.

For some people, nasal irrigation can wash out allergens and thick or dry mucus, making the nasal passages more clear and providing relief from allergy symptoms, sinus issues, and congestion.

Nasal irrigation can also reduce post-nasal drip. Some people also use a neti pot to moisten their nasal passages when they’re feeling dry from being in heated or air conditioned indoor spaces.

But nasal irrigation has risks, and can increase your risk for infections if performed improperly.

It can even be deadly.

Tap water can contain bacteria and other single-cell organisms, like amoebas, that can cause dangerous infections.

That’s why nasal irrigation should only be performed with distilled water, water that has been boiled and cooled, or water that has been passed through a special filter that can catch these dangerous organisms.

How to Do a Nasal Irrigation

Nasal irrigation is often performed using a neti pot—a small, teapot-like container.

But a sinus flush can also be performed with cupped hands, a syringe with a bulb, and even a nasal irrigation machine. 

No matter which method you use, the process is relatively similar, and has the same requirements for water: It shouldn’t be plain tap water.

Tap water can have an amoeba called Naegleria swimming in it.

Your stomach acid can kill this amoeba, so it’s still safe to drink. But if it gets in your nose, it can cause an infection—and even death. 

To make sure your nasal irrigation water is Naelgeria-free, use only distilled water, tap water that has been boiled and then left to cool to room temperature, or water that has been passed through a filter that is specifically designed to trap these ameobas.

Once your water is ready, follow these steps to perform a sinus flush.

Step One: Prepare your nasal irrigation device and solution

Before beginning, make sure your hands and your neti pot or other nasal irrigation device are clean and try.

The saline solution for nasal irrigation can either be purchased as a mix, or you can make it yourself—for every one cup of distilled, boiled, or filtered water, add a half-teaspoon of kosher salt and a half-teaspoon of baking soda.

Put this saline solution into your neti pot or other irrigation device, and stand in front of a sink.

Step Two: Get the device into position

Stand with your head over the sink, and tilt your head at a 45-degree angle.

Place the tip of the neti pot or your other device into the nostril that is higher.

It doesn’t need to be deep inside your nose—just a half-inch or so is enough.

Step Three: Pour the solution through your nostrils

In this same position, breathe through your mouth as you pour the solution into your nostril.

Continue breathing through your mouth, and try not to swallow the solution.

The liquid should begin to drain out of the other nostril into the sink.

Blow your nose after you’re finished, and repeat on the other side.

When you’re finished, clean and dry your neti pot or other device.

Nasal Irrigation Side Effects

The side effects of nasal irrigation are minimal, but some people do experience minor nasal irritation after performing a flush.

The first few times you perform a sinus flush, you may feel a slight burning; this is not a cause for concern.

Some people also experience nosebleeds or headaches after sinus flushing.

If you experience any of these side effects, stop using the neti pot and talk to your doctor before using it again.

Safety

For safety, never perform a nasal irrigation using tap water, or a saline solution created from tap water that has not been filtered or boiled.

Water from the tap can contain bacteria and other single-cell organisms, like certain amoebas.

While this water is safe to drink because of the acidity of your digestive system, these organisms can grow inside your nose and cause dangerous infections.

That’s why nasal irrigation should be performed with water that is free of these contaminants—either distilled water, water that has been passed through a filter designed to catch these organisms, or water that been boiled and then allowed to cool to room temperature.

If you would like to boil and cool tap water, bring the water to a boil for three to five minutes, then allow it to cool to room temperature before using.

When performing a nasal irrigation, water should neither be very hot nor very cool to prevent damage to your nasal passages.

It’s also important to wash your hands and your nasal irrigation device—whether it’s a neti pot or another device—before and after every use.

After you finish using the device, wash it thoroughly with soap and then dry it completely so bacteria can’t grow inside.

Can you do a nasal irrigation after sinus surgery?

Yes, but ask your doctor before performing a nasal irrigation to find out about precautions you can take to avoid complications.

If you are taking any other medications through your nose, perform the nasal irrigation first, then use the nasal medications—this will help the medicine be absorbed by your sinuses.

Does Nasal Irrigation Work?

In a survey of 330 family physicians, 87 percent said they had recommended nasal irrigation to their patients.

It’s effective for people with chronic rhinosinusitis: One study found that patients with these chronic sinus infections who practiced nasal irrigation in addition to routine care showed 64 percent improvement compared to patients who used only routine care.

It has also been helpful for people who are exposed to airborne irritants in the workplace — specifically in clearing sawdust from the noses of people who are employed in woodworking.

Other studies have shown it provides relief for patients dealing with allergic rhinitis (an irritated nose caused by allergies) and upper respiratory conditions.

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How Often Should You Do Nasal Irrigation?

In some cases, it might be necessary to repeat the process several times a day.

After surgery, some doctors suggest performing nasal irrigations two to three times per day for several weeks, continuing until the fluid runs clear.

For more moderate cases, once a day will suffice.

Some patients see improvement after just a few treatments. Talk to your healthcare provider if you’re concerned about how often you feel you need to perform a sinus flush.

If you experience nosebleeds or headaches as a result of performing nasal irrigation, stop using the device and talk to your doctor.

When to See a Doctor

The sinus and cold symptoms that prompt you to perform nasal irrigation are not typically serious.

If symptoms last more than 10 days, keep coming back, or you develop a headache or fever, you should see a doctor.

If using the nasal irrigation device causes your nose to bleed or gives you headaches, talk to a healthcare provider.

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Frequently Asked Questions

What kind of water should you use for nasal irrigation?
Nasal irrigation should only be performed with distilled water, water that has passed through a filter designed to capture bacteria and amoebas, or water that has been boiled and then allowed to cool to room temperature. Never use plain tap water, and don’t use water that is very hot or very cold. The water should then be mixed into a saline solution. Many nasal irrigation devices come with a mix. But if you’d like to make one on your own, add a half-teaspoon of salt and a half-teaspoon of baking soda for every cup of water you’re going to use.
Is nasal irrigation safe?
When performed using clean hands, a clean nasal irrigation device, and sterile water, nasal irrigation can be safe. Never use regular tap water to perform a sinus flush. Use only sterile water—distilled water, water that has been boiled and cooled, or water that has been filtered with a filter that can catch certain infectious organisms. And don’t use water that’s very hot or very cold. For safety, breathe through your mouth while performing a sinus flush. And don’t perform the procedure if you have an ear infection, or if your nose is so clogged you can't breathe through it.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Sarah Malka, MD

Dr. Sarah Malka is a board certified emergency medicine physician with K Health. She completed her residency at Harvard Medical School.